Search state statutes and regulations in all 50 states and the District of Columbia to find out what rights you have in your state and what other states are doing to empower physicians and patients in the face of health insurer market power.
Annual Network Adequacy Report
Waiver Due to Failure to Contract in Local Markets
Network Access Appointment Waiting Time Standards; Quality Assurance; Disclosure and Education
Timely Access to Non-Emergency Health Care Services and Annual Timely Access and Network Reporting Requirements
Definitions; Access Plan Filing and Review Guidelines; Access Plan Updates; Access Plan Specifications; Access Criteria; Mandatory Coverage; Provider-Enrollee Ratio Requirements; Verification of Provider Credentials; Geographic Access Criteria; Exceptions to Geographic Access Criteria; Service Areas; Referral and Specialty Care Requirements; Continuity of Care and Transitional Care; Selecting and Changing Providers; Removal of Barriers to Access; Monitoring the Network; Letters of Intent; Responsibility of Contracted Services
Definitions; Network adequacy; Notice of nonrenewal or termination; Transition of services; Network transparency; Uniform electronic provider directory information
notification forms
Findings—Intent—2019 c 427; Short title; Definitions; Dispute resolution process—Determination of commercially reasonable payment amount; Requirement to provide certain information on website or upon consumer request—Requirement to provide carriers with nonemployed provider lists; Health care provider—Requirement to provide certain information on website or upon consumer request—Requirement to submit network status information to carriers; Carrier—Requirement to update website and provider directory—Requirement to provide enrollee with certain information; Application of chapter to self-funded group health plans that elect to participate in balance billing protection provisions—Annual notice to commissioner; Determining the adequacy of provider networks—Required considerations; Allowed amounts paid to nonparticipating providers; Application of state and federal requirements—Applicability information access—Waivers prohibited
Definitions; Network Adequacy Standards; Filing and Content of Access Plan; Travel Distance Standards; Appointment Waiting Time Standards; Provider-to-Enrollee Ratio Standards; Telehealth; Waiver Request Standards; Confidential Information in Access Plans
Purpose and Scope; Applicability; Definitions; Filing Procedures; Material Changes to a Network; Provider Directory Audits; Notice of Nonrenewal or Termination; Confidentiality
Network Adequacy